Diagnostic Performance of C-Reactive Protein in Neonatal Sepsis in a Tertiary Care Hospital

Abstract

Background: Neonatal sepsis is a critical condition that requires accurate diagnosis and timely treatment. Despite blood culture being the gold standard, it has a low sensitivity for sepsis. C-reactive protein (CRP) is one of several inflammatory markers released during sepsis and is useful as a general indicator of sepsis in the paediatric population. This study aimed to evaluate the diagnostic performance of CRP in a tertiary hospital.
Methods: This cross-sectional study was conducted among neonates with a clinical suspicion of sepsis in a rural region over one-year period using convenience sampling. Blood samples were taken for blood culture and CRP analysis.
Results: Blood cultures confirmed 12.7% of clinically suspected cases while 58.2% of neonates were classified as having probable sepsis, indicating a substantial proportion of culture-negative cases still having clinical features of sepsis. C-reactive protein levels were higher in early-onset sepsis compared to late-onset sepsis. We reported sensitivity of 100%, specificity of 25%, positive predictive value of 36.8% and negative predictive value of 100%. We found the best CRP
cut-off value to be 18.4 mg/L.
Conclusions: C-reactive protein is valuable in detection of neonatal sepsis, particularly for ruling out differentials. However, due to its low specificity, CRP results should be interpreted with caution, and combined with other diagnostic methods and clinical assessments.